Friday, September 10, 2010

What about Tylenol?

This month I'm talking about which drugs doctors keep in their cabinets, and so far I've covered aspirin, diphenhydramine (benadryl), and ibuprofen. So, what about tylenol (acetaminophen)? To be honest, I rarely use it. Do we keep it around in the medicine cabinet? Yes, but this is not typically my go-to pain reliever.

You may have heard that it is the number one pain reliever used in hospitals- and that may be true. Tylenol is very easy on the stomach, as opposed to NSAIDs (like ibuprofen, trade name Advil or Motrin) and probably more importantly, tylenol does not have the potential to increase bleeding (again, as compared with the NSAIDs, which do have that potential.) Therefore, people in hospitals who are post-operative or have nausea are going to do better with tylenol.

In general, ibuprofen seems to work better to lower high fevers, and there is person to person variability regarding whether tylenol or NSAIDs work better for other aches and pains. Studies show tylenol is equally effective to NSAIDs in relieving arthritis pain, despite the fact that tylenol has no anti-inflammatory effects. Tylenol has potential to harm the liver, so patients with chronic liver disease or alcoholism should avoid it completely.

Tylenol comes in many forms- liquid, melting lozenges, tablets, capsules, and caplets- all equally effective.

At any rate, I personally tend to use tylenol as an adjunct to ibuprofen. They work on different pain pathways, and have different side effect profiles, so they often are complementary. If you have a high fever and took ibuprofen only a couple hours ago, yet you are spiking again, reach for the tylenol. The same goes for headaches or other pains. Additionally, many people find that combining a tylenol together with an ibuprofen is more effective for pain relief than taking a full dose of either drug.

BOTTOM LINE: Keep Tylenol (Acetaminophen) in your medicine cabinet for fever or pain relief, especially when used in combination with ibuprofen or other NSAIDs. If you have stomach or kidney issues, Tylenol may be your pain reliever of choice!

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